The "common cold" in frail older persons: impact of rhinovirus and coronavirus in a senior daycare center.

OBJECTIVE

To evaluate the incidence and impact of rhinovirus and coronavirus infections in older persons attending daycare.

DESIGN

Prospective descriptive study.

SETTING

Three senior daycare centers in Rochester, New York.

PATIENTS

Frail older persons and staff members of the daycare centers who developed signs or symptoms of an acute respiratory illness.

MEASUREMENTS

Demographic, medical, and physical findings were recorded on subjects at baseline and during respiratory illness. Nasopharyngeal specimens for viral culture as well as acute and convalescent sera for coronavirus 229E enzyme immunoassay (EIA) were obtained for all illnesses.

RESULTS

During the 44 months of study, 352 older persons experienced 522 illnesses. Thirty-five (7%) of 522 cultures were positive for rhinovirus and 37 (8%) of 451 serologies were positive for coronavirus 229E infection. The clinical syndromes associated with rhinovirus and coronavirus infection were similar and characterized by nasal congestion, cough, and constitutional symptoms. No patient died or was hospitalized, but approximately 50% had evidence of lower respiratory tract involvement. The average illness lasted 14 days. During the same period, 113 staff developed 338 respiratory illnesses. Eight percent were identified as coronavirus and 9% as rhinovirus. Cough, sputum production, and constitutional symptoms were significantly more common among older persons.

CONCLUSIONS

Rhinovirus and coronavirus 229E are common causes of moderately debilitating acute respiratory illnesses among older persons attending daycare.